Jack R. Ross, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27302 Issued in GA

Practice address

610 19TH St
Columbus, GA 31901-1528

Phone

(706) 322-7884

Fax

(706) 660-2168

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jack.ross@sfhga.gadirect.net
• Direct secure messaging: jack.ross@gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Francis Affiliated Services LLC

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1912371220
  Medicare reassignment NPD
• Columbus Clinic, P.C.

  • Clinic/Center
  • Columbus, GA
  • NPI 1609863133
  NPD
• Mac - Macon Road LLC

  • Clinic/Center
  • Columbus, GA
  • NPI 1053599043
  NPD
• St Francis Affiliated Services LLC

  • Urgent Care Clinic/Center
  • Columbus, GA
  • NPI 1821462136
  NPD
• St. Francis Psychiatrist ,LLC

  • Psychiatry Physician
  • Columbus, GA
  • NPI 1619129541
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1497779714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9247",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319089247",
            "telephone_number": "706-322-7884",
            "fax_number": "706-660-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 19TH ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011528",
            "telephone_number": "706-322-7884",
            "fax_number": "706-660-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JACK",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "27302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000340469E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00340469B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "080031159",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I081215",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julianna P Rose, PSY.D.
• Summer Rose
• Ashley Ann Rosenkranz, LCSW
• Arielle Kiara Ross, RBT
• Elizabeth J. Ross, OTR/L, CHT
• Jasmine N Ross
• Kim Lovett Ross
• Rita V. Ross, SST
• Robert Ross I, SST II
• Shomari Ross

• Family Medicine Physician in Columbus, GA
• Providers in Columbus, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.